title: Poor quality of life in patients with urethral stricture treated with intermittent self-dilation.
abstract: OBJECTIVE
  We assessed patient perceptions of regular intermittent self-dilation in men with urethral stricture.
  
  
  METHODS
  We constructed and distributed a visual analog questionnaire to evaluate intermittent self-dilation via catheterization by men referred for urethral stricture management at a total of 4 institutions. Items assessed included patient duration, frequency, difficulty and pain associated with intermittent self-dilation as well as interference of intermittent self-dilation with daily activity. The primary outcome was patient perceived quality of life. Multivariate analysis was performed to assess factors that affected this outcome.
  
  
  RESULTS
  Included in the study were 85 patients with a median age of 68 years, a median of 3.0 years on intermittent self-dilation and a median frequency of 1 dilation per day. On a 1 to 10 scale the median intermittent self-dilation difficulty was 5.0 ± 2.7, the median pain score was 3.0 ± 2.7 and median interference with daily life was 2.0 ± 1.3. Overall quality of life in patients with stricture was poor (median score 7.0 ± 2.6 with poor quality of life defined as 7 or greater). On univariate analysis younger age (p <0.01), interference (p = 0.03), pain (p <0.01) and difficulty performing intermittent self-dilation (p = 0.03) correlated with poor quality of life in a statistically significant manner. On multivariate analysis only difficulty catheterizing (p <0.01) and younger age (p = 0.05) were statistically significant predictors. Patients with stricture involving the posterior urethra had a statistically significant increase in difficulty and decrease in quality of life (each p = 0.04).
  
  
  CONCLUSIONS
  Most patients with urethral stricture who are on intermittent self-dilation rate difficulty and pain as moderate, and inconvenience as low but report poor quality of life.
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Jessica D
authors.initials: JD
authors.lastname: Lubahn
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Lee C
authors.initials: LC
authors.lastname: Zhao
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: J Francis
authors.initials: JF
authors.lastname: Scott
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Hudak
authors.affiliation: Department of Urology, Alfred Health, Melbourne, Victoria, Australia.
authors.forename: Justin
authors.initials: J
authors.lastname: Chee
authors.affiliation: Department of Urology, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina.
authors.forename: Ryan
authors.initials: R
authors.lastname: Terlecki
authors.affiliation: Department of Urology, University of California-San Francisco, San Francisco, California.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Breyer
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: Allen.morey@utsouthwestern.edu.
authors.forename: Allen F
authors.initials: AF
authors.lastname: Morey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004106:Dilatation / Q000379:methods / Q000523:psychology; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012648:Self Care; D014525:Urethral Stricture / Q000523:psychology / Q000628:therapy*; D014546:Urinary Catheterization / Q000379:methods / Q000523:psychology; D055815:Young Adult
keywords: ISC; ISD; QOL; catheterization; contracture; intermittent self-catheterization; intermittent self-dilation; quality of life; questionnaires; urethral stricture; urinary bladder neck obstruction